Abstract:

Background: Among other reasons for decreasing maternal mortality ratio is the utilization of community health workers. This study gives insights on how the program can utilize community health workers by understanding their performance, satisfaction and their associated factors toward providing community-based health care. This study was designed to explore the factors influencing the community health workers’ job satisfaction and their performance to the provision of community-based health care.

Methods: It was a community-based cross-sectional study conducted in Misungwi and Kwimba, involving 240 respondents. The study deployed qualitative and quantitative approaches.

Results: Quantitatively, there was a relatively equal satisfaction level; 50.4% and 49.6% of CHWs reported a low and high level of satisfaction respectively. CHWs of ≥35 years were more likely to report high satisfaction (OR=2.05, p<0.006). The relationship between the satisfaction and number of children (≥3 children) (OR=1.985, p<0.022) and the number of households served in the community (≥134 households) (OR=0.495, p<0.021 were statistically significant of the performance (AOR=2.728, 95%CI: 1.166-6.382; p<0.021). Performance and satisfaction expressed a positive association (AOR= 4.069, 95%CI: 1.530-10.822; p<0.005)

Qualitatively: Selection process, community acceptance, acknowledgement, training and orientations, and the relationship with health care workers were highlighted as key factors to the performance. Satisfaction to provide CBMNCH services was due to the feelings, readiness to serve their community and community recognition.

Conclusion: The performance and job satisfaction among the community health workers was high and comparable between both districts. Age, Number of children, and the number of households had a direct impact on their performance and satisfaction or performance. Therefore, the CBMNCH program should put into consideration the selection process, relationship with the health facilities and acknowledgment.

Ethical Considerations: Ethical approval was obtained from CHUHAS/BMC Joint Review Committee. Permission to conduct the study was granted as this was part of the ongoing project implementation in the study districts

Plan for Dissemination: The findings of this study are useful to various stakeholders such as the Region and Districts Health Management teams for CHWs initiative strengthening in the provision of health promotion at the community.